Band adhesions not related to previous abdominal surgery – A retrospective cohort analysis of risk factors

Skoglar, Andreas; Gunnarsson, Ulf; Falk, Peter

doi:10.1016/j.amsu.2018.11.007

Cited by 17 publications

(24 citation statements)

References 30 publications

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“…Fibrous bands are a type of adhesion found in several species, including horses (Moll et al 1993;Gandini et al 2005;Di Cicco et al 2011;Skoglar et al 2018), which might lead to small intestinal obstructions, although they have been rarely reported in horses. They can form either after a previous surgery or not (Strik et al 2016;Skoglar et al 2018), although in humans, it seems that solitary fibrous bands are more common in patients that had not undergone a previous surgery, suggesting that other factors might predispose to adhesion formations (Skoglar et al 2018).…”

Section: Discussionmentioning

confidence: 99%

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Strangulating obstruction of the small intestine by a fibrous band originating on the nephrosplenic ligament

Gandini

Labate

Rosso

et al. 2019

Equine Veterinary Education

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Summary During a laparotomy for colic signs in a 2‐year‐old male Thoroughbred, a portion of approximately 7 m of the jejunum was found entrapped in a fibrous band originating from the nephrosplenic ligament. The entrapped jejunum was necrotic and was removed. Two months after the first surgery, a laparoscopy was performed to close the nephrosplenic space and it was possible to identify several fibrous bands bridging from the renal capsule to the splenic capsule and a fibrotic plate over the spleen. This is the first report of a strangulating obstruction of the jejunum in the nephrosplenic space and of fibrous bands bridging from the nephrosplenic ligament to the spleen. The fibrous bands were likely due to inflammation caused by previous, multiple left dorsal displacements of the bowel, which resolved spontaneously.

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Section: Discussionmentioning

confidence: 99%

“…Fibrous bands are a type of adhesion found in several species, including horses (Moll et al 1993; Gandini et al 2005; Di Cicco et al 2011; Skoglar et al . 2018), which might lead to small intestinal obstructions, although they have been rarely reported in horses. They can form either after a previous surgery or not (Strik et al .…”

Section: Discussionmentioning

confidence: 99%

Strangulating obstruction of the small intestine by a fibrous band originating on the nephrosplenic ligament

Gandini

Labate

Rosso

et al. 2019

Equine Veterinary Education

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“…The differentiation of these two types of adhesions is of clinical importance because the causes and complications may be different, with each resulting in specific treatment needs. In patients without a history of abdominal surgery, a single adhesive band is more common than multiple matted adhesions (13). Adhesive SBO from a solitary band is more likely to cause strangulation compared with adhesive SBO caused by matted adhesions (12).…”

Section: Issues Relevant To Surgical Managementmentioning

confidence: 99%

“…Imaging is also being investigated as a means of accurately differentiating between open-loop adhesive SBO and closed-loop adhesive SBO and of determining how this difference may influence the management strategy (9)(10)(11). Whether matted adhesions can be reliably differentiated from single-band adhesions and require a different treatment is also of interest (12,13). Finally, the ability of imaging studies to help predict the success or failure of nonoperative management is being assessed (14).…”

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confidence: 99%

Adhesive Small Bowel Obstruction: Predictive Radiology to Improve Patient Management

2020

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Adhesive small bowel obstruction (SBO) remains one of the leading causes of emergency room visits and is still associated with high morbidity and mortality rates. Because the management of adhesive SBO has shifted from immediate surgery to nonoperative treatment in the absence of ischemia, it is crucial to rapidly detect or predict strangulation, which requires emergent surgery. CT is now established as the best imaging technique for the initial assessment of patients suspected of having adhesive SBO. CT helps confirm the diagnosis of mechanical SBO, locate the site of obstruction, establish the cause, and detect complications. This article is a review of the role of imaging in answering specific questions to help predict the management needs of each individual patient. It includes (a) an update on the best CT signs for predicting ischemia and a need for bowel resection; (b) a discussion of the CT features that help differentiate open-loop from closed-loop obstruction and a single adhesive band from matted adhesions and how these differences can influence the management; and (c) a review of the main CT predictors of the success or failure of nonoperative management in adhesive SBO.

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“…In contrast, developing countries, etiology includes adhesions (34%), hernia (16%), malignancy (13.5%) and tuberculous stricture (10%); acute intestinal obstruction due to foreign bodies is rare in adults. Previous abdominal surgery does not represent a dominant risk factor for SBO caused by solitary band adhesions, unlike SBO caused by matted adhesions; while in patients with no history of previous abdominal surgery (virgin abdomen) the risk for bowel obstruction is usually due to a solitary band [1,2]. The diagnosis of SBO in the Emergency Department (ED) has been estimated to be around 2% of all patients who presented with abdominal pain and 15% of all patients who ultimately get admitted to the surgical unit from the ED [3,4,5,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Ultrasound in the Diagnosis of Small Bowel Obstruction

Tamburrini¹,

Lugarà²,

Iaselli³

et al. 2019

Diagnostics

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Introduction: Small bowel obstruction (SBO) is a common presentation to the Emergency Department (ED). This study aimed to analyze the accuracy of ultrasound (US) in diagnosing and staging SBO. Objectives: The main object of this study was to analyze the accuracy of ultrasound in diagnosing and staging SBO compared to CT. Methods: Retrospectively, stable patients with an ultrasonographic diagnosis of SBO who underwent abdominal CT immediately after US and before receiving naso-intestinal decompression, were included. US criteria for the diagnosis of SBO were related to morphological and functional findings. US diagnosis of obstruction was made if fluid-filled dilated small bowel loops were detected, peristalsis was abnormal and parietal abnormalities were present. Morphologic and functional sonographic findings were assigned to three categories: simple SBO, compensated SBO and decompensated SBO. US findings were compared with the results of CT examinations: Morphologic CT findings (divided into loop, vascular, mesenteric and peritoneal signs) allowed the classification of SBO in simple, decompensated and complicated. Results: US diagnostic accuracy rates in relation to CT results were calculated: ultrasound compared to CT imaging, had a sensitivity of 92.31% (95% CI, 74.87% to 99.05%) and a specificity of 94.12% (95% CI, 71.31% to 99.85%) in the diagnosis of SBO. Conclusions: This study, similarly to the existing literature, suggests that ultrasound is highly accurate in the diagnosis of SBO, and that the most valuable sonographic signs are the presence of dilated bowel loops ad abnormal peristalsis.

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Band adhesions not related to previous abdominal surgery – A retrospective cohort analysis of risk factors

Cited by 17 publications

References 30 publications

Strangulating obstruction of the small intestine by a fibrous band originating on the nephrosplenic ligament

Strangulating obstruction of the small intestine by a fibrous band originating on the nephrosplenic ligament

Adhesive Small Bowel Obstruction: Predictive Radiology to Improve Patient Management

Diagnostic Accuracy of Ultrasound in the Diagnosis of Small Bowel Obstruction

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